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Document BP-A0489

AI Analysis

Summary: This document is a completed HIV counseling form for inmate Tyler Son, dated February 4, 2015. It outlines the pretest counseling provided, including explanation of the HIV test, risk factors, and informed consent. The form was signed by both the inmate and the staff counselor.
Significance: This document is potentially important as it provides evidence of HIV counseling and testing procedures followed within a correctional facility, and may be relevant in cases involving inmate health care or HIV transmission.
Key Topics: HIV testing and counseling procedures Risk factors and clinical signs for HIV Informed consent for HIV testing
Key People:
  • Tyler Son - Inmate receiving HIV counseling
  • (b)(6), (b)(7)(C) - Staff Counselor providing HIV counseling
Document Type
Medical Record
Date
JUN 10
Pages
1
Folder
IMAGES009
Has Handwriting
Yes

Full Text

BP-A0489 JUN 10 U.S. DEPARTMENT OF JUSTICE FEDERAL BUREAU OF PRISONS HIV COUNSELING DOCUMENTATION Directions: Use the following criteria to counsel the patient who is tested for the HIV antibody. Check off each item as they are discussed. Write NA beside any item that is inappropriate to the situation. The reverse side of this form will be utilized to document seronegative and inconclusive test result. Then file in the patient's record, documenting in progress notes that counseling was completed. PRETEST: 1. Explain purpose of session. 2. Explain confidentiality. 3. Explain HIV antibody test. a. What HIV is b. What the test is c. Test Procedure d. Meaning of test results e. Inability of detecting early infection (false negatives) f. Potential need for additional testing g. Significance of a positive test 4. List risk factors/clinical signs: (check all that apply) a. Injecting drug use, sharing drug or tattoo equipment b. Unprotected or multiple sex partners c. Treated for: sexually transmitted infections, hepatitis, or TB d. Clinical s/s: fever or illness of unknown cause, symptoms of AIDS opportunistic infections. e. Exposure: recent occupational or non-occupational exposure/incident. f. Pregnant female g. Other 5. Obtain informed consent (when applicable). 6. Risk Reduction Behaviors. Educational material given. 7. Patient Reactions/Comments. 8. Explain how the patient will be notified of the result. The above information has been explained to me in a language I can understand. Signature of Inmate Tyler Son Date: 2/4/15 76310-065 Signature of Staff Counselor (b)(6), (b)(7)(C) Date: (b)(6), (b)(7)(C) Inmate Name: Register No.: Institution: File in the Medical Record: Section 6. Prescribed by P6190 Replaces BP-S489.061 of APR DOJ-OGR-00024176